本文選題：手法復(fù)位 + 經(jīng)皮穿針　； 參考：《福建中醫(yī)藥大學(xué)》2015年碩士論文

【摘要】：目的：通過對手法復(fù)位經(jīng)皮張力帶固定治療髕骨骨折的臨床研究,尋求一種創(chuàng)傷小、并發(fā)癥少、操作簡便、療效可靠的治療髕骨骨折的方法,以便在臨床推廣應(yīng)用。方法：選取2013年3月至2014年6月山東省文登整骨醫(yī)院創(chuàng)傷整復(fù)科收治的符合診斷及納入標(biāo)準(zhǔn)的髕骨骨折患者共60例,采用隨機(jī)排列法分為A(治療組)、B(對照組)兩組,每組30例,A組采用手法復(fù)位經(jīng)皮張力帶固定,B組采用切開復(fù)位張力帶內(nèi)固定,術(shù)后兩組均給予石膏托或支具固定,應(yīng)用抗生素1-3d,1周后去除外固定行膝關(guān)節(jié)屈伸功能訓(xùn)練,6-8周后視膝關(guān)節(jié)功能鍛煉情況及拍片骨折愈合情況擇期取出內(nèi)固定。術(shù)后對所有病例進(jìn)行定期隨訪,通過參照Bostman臨床評分標(biāo)準(zhǔn)對膝關(guān)節(jié)功能進(jìn)行評定,并對兩組患者手術(shù)時間、住院時間、骨折臨床愈合時間及膝關(guān)節(jié)活動度等進(jìn)行統(tǒng)計(jì)分析。結(jié)果：所有患者隨訪3-6個月,平均5個月。術(shù)后對照組出現(xiàn)1例刀口淺表感染,后經(jīng)治療刀口愈合,其余未出現(xiàn)針眼或刀口感染、骨折不愈合、皮膚壞死、患處再受傷等情況,對兩組患者的手術(shù)時間、住院時間、骨折臨床愈合時間及膝關(guān)節(jié)活動度等進(jìn)行統(tǒng)計(jì)分析發(fā)現(xiàn)除手術(shù)時間相當(dāng)外,其余觀察指標(biāo)治療組明顯優(yōu)于對照組(P0.05),通過參照Bostman臨床評分標(biāo)準(zhǔn)對兩組術(shù)后12周膝關(guān)節(jié)功能進(jìn)行統(tǒng)計(jì)分析發(fā)現(xiàn)無統(tǒng)計(jì)學(xué)差異(P0.05)。結(jié)論：從各項(xiàng)統(tǒng)計(jì)資料來看,盡管治療組與對照組手術(shù)時間及術(shù)后12周膝關(guān)節(jié)功能相當(dāng),但前者創(chuàng)傷更小,感染機(jī)會少,住院時間短,骨折愈合快,無需再次廣泛切開取出內(nèi)固定,且術(shù)后不留明顯瘢痕,是一種較為理想的治療方法,值得在臨床推廣應(yīng)用。
[Abstract]:Objective: to explore a simple and effective method for the treatment of patellar fracture with manual reduction and percutaneous tension band fixation for the treatment of patellar fracture with less trauma, less complications, simple operation and reliable curative effect. Methods: from March 2013 to June 2014, 60 patients with patellar fracture who were admitted to Department of Trauma and Restoration, Wendeng whole Bone Hospital, Shandong Province, were randomly divided into two groups: group A (treatment group) and group B (control group). Each group (30 cases) was treated with manual reduction and percutaneous tension band fixation. Group B was treated with open reduction and tension band internal fixation. The knee joint flexion and extension function training was carried out after 1 week with antibiotics for 1 3 d and the internal fixation was taken out after 6 to 8 weeks of visual knee joint function exercise and fracture healing. All the patients were followed up regularly after operation. The knee joint function was evaluated by referring to Bostman's clinical score. The operation time, hospitalization time, fracture healing time and knee motion were statistically analyzed in the two groups. Results: all patients were followed up for 3-6 months with an average of 5 months. In the control group, one case appeared superficial infection of the knife edge after operation, and the other cases did not have needle eye or knife edge infection, fracture nonunion, skin necrosis, injury of the affected area, etc. The operation time and hospitalization time of the patients in the two groups were analyzed. The clinical healing time and knee motion of fracture were statistically analyzed. The other observation indexes in the treatment group were significantly better than that in the control group (P 0.05). The knee joint function of the two groups was statistically analyzed 12 weeks after operation according to the Bostman clinical score. No statistical difference was found between the two groups (P 0.05). Conclusion: according to the statistical data, although the operation time and function of knee joint in the treatment group and the control group are the same, the former has less trauma, less chance of infection, shorter hospital stay and faster fracture healing. It is an ideal method to remove internal fixation without extensive incision and no obvious scar after operation, which is worth popularizing in clinical practice.
【學(xué)位授予單位】：福建中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R687.3

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